AI has been the talk of the healthcare industry, garnering excitement for its potential to improve patient care, as well as concern for the need to implement it ethically. But does the technology have the potential to reduce health disparities?
That was the question posed during a debate at the Reuters Total Health conference held in Chicago on Wednesday. The debate was between Anil Saldanha, chief innovation officer of Rush University System for Health, and Rebecca Kaul, PhD, senior vice president and chief of digital innovation & transformation at Northwell Health.
Saldanha said he takes a negative view on the topic, stating that AI isn’t there yet to reduce health disparities.
“In my opinion, it’s going to amplify for some time,” Saldanha argued. “And I don’t have a time frame when it will equalize or get better. The reason has nothing to do with AI. In general, from an industry perspective, we’re still struggling to bring health equity to our communities in everything we do in healthcare. So the job’s not complete, and now we introduce this new paradigm called AI. While AI might bring in improvements in efficiency, AI is not there to replace your doctor, for example. So in no way do I feel it’s there to help with health equity right now.”
Kaul, meanwhile, argued that what matters is how people use AI, and she believes that people are going to use it in a way that’s ethical and will close disparities.
“I think that, fundamentally, we are healthcare professionals,” she said. “We come at it with ‘a do no harm, do good’ type perspective. … It can close the gaps in terms of giving greater access to care, whether it be through surfacing information for people that maybe don’t have in-person access to care. They can start to understand more about their health conditions using AI. It can provide clinicians that are in rural communities with access to specialists.”
She added that the technology can make care more personalized and reduce language barriers. She claimed that AI has the ability to translate into over 80 languages.
Saldanha pushed back, saying that data integrity is a major challenge in the healthcare industry and that AI “is only as good as the data it’s trained on.” When AI hasn’t been fed the right data, the industry can’t expect to use it to solve disparities, he argued.
Kaul responded that knowing that data sets often have bias “allows us to train the models, modify the models to take that bias out, and to also then find data sets to feed it to introduce the kind of diversity into the data for training purposes.”
In closing arguments, Saldanha emphasized that he doesn’t think AI is going to help with the disparities healthcare has. He gave the example of a program used in Chicago called ShotSpotter, which uses sensors to detect gunshots. The program was recently discontinued, though there are efforts to keep it in place, according to Block Club Chicago.
“The criticism of this program is that it’s invariably deployed in communities of color and neighborhoods with the most disparities,” he said. “The champions say that it can help with gun violence and prevention. The jury is still out.”
Kaul argued that it’s not about whether AI is ready to reduce disparities, but whether healthcare organizations are ready to use the technology to close gaps.
“All of the signals I’m seeing from both my own organization and the market would be a resounding yes,” she said. “There’s a lot of discussion about ethical use of AI. A lot of the use cases being brought forward are about equalizing disparities. We’re seeing governance models around making sure that there are no unintentional bad things happening in any of the use cases people are setting forth.”
The audience seemed to mostly agree with Kaul. In a poll shared at the end of the debate, 47% of the audience said that they believe AI somewhat has the potential to reduce disparities, while 42% said it significantly does. Another 11% said “no, not really.”
Photo: Sylverarts, Getty Images
